tbuckley/cabot-search huggingface dataset:
The Association of Sodium-Glucose Cotransporter 2 Inhibitors With Cardiovascular Outcomes in Anthracycline-Treated Patients With Cancer
Authors: Husam Abdel-Qadir, Rodrigo Carrasco, Peter C. Austin, Yue Chen, Limei Zhou, Jiming Fang, Henry M.H. Su, Iliana C. Lega, Padma Kaul, Tomas G. Neilan, Paaladinesh Thavendiranathan
Journal: JACC CardioOncology (2023)

Sodium glucose cotransporter-2 inhibitors (SGLT2is) are hypothesized to reduce the risk of anthracycline-associated cardiotoxicity. This study sought to determine the association between SGLT2is and cardiovascular disease (CVD) after anthracycline-containing chemotherapy. Using administrative data sets, we conducted a population-based cohort study of people >65 years of age with treated diabetes and no prior heart failure (HF) who received anthracyclines between January 1, 2016, and December 31, 2019. After estimating propensity scores for SGLT2i use, the average treatment effects for the treated weights were used to reduce baseline differences between SGLT2i-exposed and -unexposed controls. The outcomes were hospitalization for HF, incident HF diagnoses (in- or out-of-hospital), and documentation of any CVD in future hospitalizations. Death was treated as a competing risk. Cause-specific HRs for each outcome were determined for SGLT2i-treated people relative to unexposed controls. We studied 933 patients (median age 71.0 years, 62.2% female), 99 of whom were SGLT2i treated. During a median follow-up of 1.6 years, there were 31 hospitalizations for HF (0 in the SGLT2i group), 93 new HF diagnoses, and 74 hospitalizations with documented CVD. Relative to controls, SGLT2i exposure was associated with HR of 0 for HF hospitalization (P < 0.001) but no significant difference in incident HF diagnosis (HR: 0.55; 95% CI: 0.23-1.31; P = 0.18) or CVD diagnosis (HR: 0.39; 95% CI: 0.12-1.28; P = 0.12). There was no significant difference in mortality (HR: 0.63; 95% CI: 0.36-1.11; P = 0.11). SGLT2is may reduce the rate of HF hospitalization after anthracycline-containing chemotherapy. This hypothesis warrants further testing in randomized controlled trials.
Endothelin Receptor Blocker Reverses Breast Cancer–Induced Cardiac Remodeling
Authors: Zaid H. Maayah, Mourad Ferdaoussi, Aristeidis E. Boukouris, Shingo Takahara, Subhash K. Das, Mostafa Khairy, John R. Mackey, Edith Pituskin, Gopinath Sutendra, D. Ian Paterson, Jason R.B. Dyck
Journal: JACC CardioOncology (2023)

Although some cancer therapies have overt and/or subclinical cardiotoxic effects that increase subsequent cardiovascular risk in breast cancer patients, we have recently shown that the breast tumor itself can also induce cardiac hypertrophy through the activation of the endothelin system to contribute to cardiovascular risk. However, the extent to which the suppression of the activation of the endothelin system could improve cardiac remodeling in breast cancer patients has yet to be investigated.We aimed to retrospectively assess the cardiac morphology/function in patients with breast cancer before receiving cancer chemotherapy and to investigate if the suppression of the activation of the endothelin system improves cardiac remodeling in a mouse model of breast cancer.Our study involved 28 previously studied women with breast cancer (including 24 after tumor resection) before receiving adjuvant therapy and 17 control healthy women. In addition, we explored how the endothelin system contributed to breast cancer-induced cardiac remodeling using a mouse model of breast cancer.Our results indicate that before chemotherapy, breast cancer patients already exhibit relative cardiac remodeling and subclinical cardiac dysfunction, which was associated with the activation of the endothelin system. Importantly, our mouse data also show that the endothelin receptor blocker atrasentan significantly lessened cardiac remodeling and improved cardiac function in a preclinical model of breast cancer.Although our findings should be further examined in other preclinical/clinical models, our data suggest that endothelin receptor blockers may play a role in cardiac health in individuals with breast cancer. (Understanding and Treating Heart Failure With Preserved Ejection Fraction: Novel Mechanisms, Diagnostics and Potential Therapeutics [Alberta HEART]; NCT02052804 and Multidisciplinary Team Intervention in Cardio-Oncology [TITAN]; NCT01621659).
The Economic Burden of Elevated Blood Glucose Levels in 2012: Diagnosed and Undiagnosed Diabetes, Gestational Diabetes Mellitus, and Prediabetes
Authors: Timothy M. Dall, Wenya Yang, Pragna Halder, Bo Pang, Marjan Massoudi, Neil Wintfeld, April P. Semilla, Jerry Franz, Paul F. Hogan
Journal: Diabetes Care (2014)

OBJECTIVE To update estimates of the economic burden of undiagnosed diabetes, prediabetes, and gestational diabetes mellitus in 2012 in the U.S. and to present state-level estimates. Combined with published estimates for diagnosed diabetes, these statistics provide a detailed picture of the economic costs associated with elevated glucose levels. RESEARCH DESIGN AND METHODS This study estimated health care use and medical expenditures in excess of expected levels occurring in the absence of diabetes or prediabetes. Data sources that were analyzed include Optum medical claims for ∼4.9 million commercially insured patients who were continuously enrolled from 2010 to 2012, Medicare Standard Analytical Files containing medical claims for ∼2.6 million Medicare patients in 2011, and the 2010 Nationwide Inpatient Sample containing ∼7.8 million hospital discharge records. The indirect economic burden includes reduced labor force participation, missed workdays, and reduced productivity. State-level estimates reflect geographic variation in prevalence, risk factors, and prices. RESULTS The economic burden associated with diagnosed diabetes (all ages) and undiagnosed diabetes, gestational diabetes, and prediabetes (adults) exceeded $322 billion in 2012, consisting of $244 billion in excess medical costs and $78 billion in reduced productivity. Combined, this amounts to an economic burden exceeding $1,000 for each American in 2012. This national estimate is 48% higher than the $218 billion estimate for 2007. The burden per case averaged $10,970 for diagnosed diabetes, $5,800 for gestational diabetes, $4,030 for undiagnosed diabetes, and $510 for prediabetes. CONCLUSIONS These statistics underscore the importance of finding ways to reduce the burden of prediabetes and diabetes through prevention and treatment.
Outcomes of Postoperative Overnight High-Acuity Care in Medium-Risk Patients Undergoing Elective and Unplanned Noncardiac Surgery
Authors: Guy Ludbrook, Michael P. W. Grocott, Kathy Heyman, Sandy Clarke-Errey, Colin Royse, Jamie Sleigh, L. Bogdan Solomon
Journal: JAMA Surgery (2023)

Postoperative complications are increasing, risking patients' health and health care sustainability. High-acuity postoperative units may benefit outcomes, but existing data are very limited.To evaluate whether a new high-acuity postoperative unit, advanced recovery room care (ARRC), reduces complications and health care utilization compared with usual ward care (UC).In this observational cohort study, adults who were undergoing noncardiac surgery at a single-center tertiary adult hospital, anticipated to stay in hospital for 2 or more nights, were scheduled for postoperative ward care, and at medium risk (defined as predicted 30-day mortality of 0.7% to 5% by the National Safety Quality Improvement Program risk calculator) were included. Allocation to ARRC was based on bed availability. From 2405 patients assessed for eligibility with National Safety Quality Improvement Program risk scoring, 452 went to ARRC and 419 to UC, with 8 lost to 30-day follow-up. Propensity scoring identified 696 patients with matched pairs. Patients were treated between March and November 2021, and data were analyzed from January to September 2022.ARRC is an extended postanesthesia care unit (PACU), staffed by anesthesiologists and nurses (1 nurse to 2 patients) collaboratively with surgeons, with capacity for invasive monitoring and vasoactive infusions. ARRC patients were treated until the morning after surgery, then transferred to surgical wards. UC patients were transferred to surgical wards after usual PACU care.The primary end point was days at home at 30 days. Secondary end points were health facility utilization, medical emergency response (MER)-level complications, and mortality. Analyses compared groups before and after propensity scoring matching.Of 854 included patients, 457 (53.5%) were male, and the mean (SD) age was 70.0 (14.4) years. Days at home at 30 days was greater with ARRC compared with UC (mean [SD] time, 17 [11] vs 15 [11] days; P = .04). During the first 24 hours, more patients were identified with MER-level complications in ARRC (43 [12.4%] vs 13 [3.7%]; P < .001), but after return to the ward, these were less frequent from days 2 to 9 (9 [2.6%] vs 22 [6.3%]; P = .03). Length of hospital stay, hospital readmissions, emergency department visits, and mortality were similar.For medium-risk patients, brief high-acuity care with ARRC allowed enhanced detection and management of early MER-level complications, which was followed by a decreased incidence of subsequent MER-level complications after discharge to the ward and by increased days at home at 30 days.
Comment on ‘Intelligent cataract surgery supervision and evaluation via deep learning’
Authors: Guoping Kuang, Ying Li, Pan Hou
Journal: International Journal of Surgery (2023)

aDepartment of Ophthalmology, The First People's Hospital of Chenzhou, Chenzhou, Hunan, 423000, China bKey Laboratory of Medical Imaging and Artificial Intelligence of Hunan Province, China cDepartment of Ophthalmology, The Affiliated Chenzhou Hospital, Hengyan Medical School, University of South China, Chenzhou, Hunan, 423000, China dDepartment of Science and Education, The Affiliated Hospital of Xiangnan University, Chenzhou, Hunan 423000, China Guoping Kuang and Ying Li: These authors contributed equally to this work. Running Title: Intelligent cataract surgery and deep learning. Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. Published online ■ ■ *Corresponding author. Address: Department of Ophthalmology, The First People's Hospital of Chenzhou, Chenzhou, Hunan, 423000, China. E-mail address: [email protected] (G. Kuang). This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/
Target Trial Emulation to Improve Causal Inference from Observational Data: What, Why, and How?
Authors: Edouard L. Fu
Journal: Journal of the American Society of Nephrology (2023)

ABSTRACT Target trial emulation has drastically improved the quality of observational studies investigating the effects of interventions. Its ability to prevent avoidable biases that have plagued many observational analyses has contributed to its recent popularity. This review explains what target trial emulation is, why it should be the standard approach for causal observational studies that investigate interventions, and how to do a target trial emulation analysis. We discuss the merits of target trial emulation compared with often used, but biased analyses, as well as potential caveats, and provide clinicians and researchers with the tools to better interpret results from observational studies investigating the effects of interventions.
BCG Vaccine Not Effective Against COVID-19
Authors: Emily Harris
Journal: JAMA (2023)

ACA Had "Minimal" Effect on Health Insurance StabilityAlthough the Affordable Care Act (ACA) reduced the proportion of uninsured US residents from 20% to 12.5% in any given month, the legislation had little effect on their ability to maintain health coverage, according to a recent study.The researchers analyzed coverage data in 2-year increments between 2007 and 2013 (the pre-ACA period) as well as between 2014 (the post-ACA period) and 2019 (the pre-COVID-19 period).Their findings showed that the proportion of people who lost their insurance during a 2-year period was similar: 14% pre-ACA and 12% afterward.The researchers noted that much of the ACA's increased coverage came from Medicaid expansions and the creation of private health insurance exchanges-2 sources that can be quite unstable.In fact, they reported that in the post-ACA era, about 20% of people with coverage through Medicaid or an exchange were likely to lose their insurance during a 2-year period compared with 8.5% of those with employer-based insurance."Perversely, we find that US health insurance coverage-whose very purpose is to provide a measure of certainty in an uncertain world-is itself highly uncertain," the researchers wrote in
Course of Subtypes of Late-Life Depression Identified by Bipartite Network Analysis During Psychosocial Interventions
Authors: Nili Solomonov, Jihui Lee, Samprit Banerjee, Serena Z. Chen, Jo Anne Sirey, Faith M. Gunning, Connor Liston, Patrick J. Raue, Patricia A. Areán, George S. Alexopoulos
Journal: JAMA Psychiatry (2023)

Approximately half of older adults with depression remain symptomatic at treatment end. Identifying discrete clinical profiles associated with treatment outcomes may guide development of personalized psychosocial interventions.
POSITIVE Results for Breast Cancer Survivors Who Desire Pregnancy
Authors: Sharon H. Giordano
Journal: New England Journal of Medicine (2023)

Advances in cancer screening and treatment have led to a large and growing population of cancer survivors. In the United States, the number of cancer survivors is expected to increase from approximately 15 million in 2016 to 26 million by 2040.1 Cancer survivors are at risk for many long-term and late effects related to their previous cancer treatments, including the loss of fertility owing to treatment with chemotherapy, radiation therapy, or both. The potential loss of fertility can be a major source of distress for young patients with cancer, and professional guidelines recommend that the possibility of infertility be addressed . . .
Patient Preference in Physician Decision-Making for Patients With Low- to Intermediate-Risk Differentiated Thyroid Cancer
Authors: Max A. Schumm, Michelle L. Shu, Angela M. Leung, Masha J. Livhits, Michael W. Yeh, Greg D. Sacks, James X. Wu
Journal: JAMA Surgery (2023)

This survey study describes the association between patient preference and physician decision-making in thyroid cancer.
Interrupting Endocrine Therapy to Attempt Pregnancy after Breast Cancer
Authors: Ann H. Partridge, Samuel M. Niman, Monica Ruggeri, Fedro A. Peccatori, Hatem A. Azim, Marco Colleoni, Cristina Saura, Chikako Shimizu, Anna B. Sætersdal, Judith R. Kroep, Audrey Mailliez, Ellen Warner, Virginia F. Borges, Frédéric Amant, Andrea Gombos, Akemi Kataoka, Christine Rousset-Jablonski, Simona Borstnar, Junko Takei, Jeong E. Lee, Janice M. Walshe, Manuel Ruíz-Borrego, Halle C.F. Moore, Christobel Saunders, Vesna Bjelic-Radisic, Snezana Susnjar, Fatima Cardoso, Karen L. Smith, Teresa Ferreiro, Karin Ribi, Kathryn Ruddy, Roswitha Kammler, Sarra El-Abed, Giuseppe Viale, Martine Piccart, Larissa A. Korde, Aron Goldhirsch, Richard D. Gelber, Olivia Pagani
Journal: New England Journal of Medicine (2023)

Prospective data on the risk of recurrence among women with hormone receptor–positive early breast cancer who temporarily discontinue endocrine therapy to attempt pregnancy are lacking. Download a PDF of the Research Summary. We conducted a single-group trial in which we evaluated the temporary interruption of adjuvant endocrine therapy to attempt pregnancy in young women with previous breast cancer. Eligible women were 42 years of age or younger; had had stage I, II, or III disease; had received adjuvant endocrine therapy for 18 to 30 months; and desired pregnancy. The primary end point was the number of breast cancer events (defined as local, regional, or distant recurrence of invasive breast cancer or new contralateral invasive breast cancer) during follow-up. The primary analysis was planned to be performed after 1600 patient-years of follow-up. The prespecified safety threshold was the occurrence of 46 breast cancer events during this period. Breast cancer outcomes in this treatment-interruption group were compared with those in an external control cohort consisting of women who would have met the entry criteria for the current trial. Among 516 women, the median age was 37 years, the median time from breast cancer diagnosis to enrollment was 29 months, and 93.4% had stage I or II disease. Among 497 women who were followed for pregnancy status, 368 (74.0%) had at least one pregnancy and 317 (63.8%) had at least one live birth. In total, 365 babies were born. At 1638 patient-years of follow-up (median follow-up, 41 months), 44 patients had a breast cancer event, a result that did not exceed the safety threshold. The 3-year incidence of breast cancer events was 8.9% (95% confidence interval [CI], 6.3 to 11.6) in the treatment-interruption group and 9.2% (95% CI, 7.6 to 10.8) in the control cohort. Among select women with previous hormone receptor–positive early breast cancer, temporary interruption of endocrine therapy to attempt pregnancy did not confer a greater short-term risk of breast cancer events, including distant recurrence, than that in the external control cohort. Further follow-up is critical to inform longer-term safety. (Funded by ETOP IBCSG Partners Foundation and others; POSITIVE ClinicalTrials.gov number, NCT02308085.) QUICK TAKE VIDEO SUMMARYInterrupting Endocrine Therapy for Pregnancy after Breast Cancer 01:57
Methods, Complications, and Outcomes in a Randomized Clinical Trial of Electroacupuncture After Colorectal Cancer Surgery—Reply
Authors: Yu Wang, Jing-Wen Yang, Cun-Zhi Liu
Journal: JAMA Surgery (2023)

In Reply We appreciate Yen and colleagues, Hu and Kao, and Yuan and colleagues for their interest in our research.1 Their insightful comments provide us with plenty of food for thought and inspiration.
Methods, Complications, and Outcomes in a Randomized Clinical Trial of Electroacupuncture After Colorectal Cancer Surgery
Authors: Ya-Ting Hu, Yung-Shuo Kao
Journal: JAMA Surgery (2023)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Surgery HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Surgery journal
Swapping Out Sugary Drinks Associated With Lower Mortality
Authors: Emily Harris
Journal: JAMA (2023)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
XBB.1.16 Deemed COVID-19 “Variant of Interest”
Authors: Emily Harris
Journal: JAMA (2023)

ACA Had "Minimal" Effect on Health Insurance StabilityAlthough the Affordable Care Act (ACA) reduced the proportion of uninsured US residents from 20% to 12.5% in any given month, the legislation had little effect on their ability to maintain health coverage, according to a recent study.The researchers analyzed coverage data in 2-year increments between 2007 and 2013 (the pre-ACA period) as well as between 2014 (the post-ACA period) and 2019 (the pre-COVID-19 period).Their findings showed that the proportion of people who lost their insurance during a 2-year period was similar: 14% pre-ACA and 12% afterward.The researchers noted that much of the ACA's increased coverage came from Medicaid expansions and the creation of private health insurance exchanges-2 sources that can be quite unstable.In fact, they reported that in the post-ACA era, about 20% of people with coverage through Medicaid or an exchange were likely to lose their insurance during a 2-year period compared with 8.5% of those with employer-based insurance."Perversely, we find that US health insurance coverage-whose very purpose is to provide a measure of certainty in an uncertain world-is itself highly uncertain," the researchers wrote in
Impact of Cold Somatostatin Analog Administration on Somatostatin Receptor Imaging
Authors: David Morland, Nicolas Laures, Elizabeth Katherine Anna Triumbari, Marine Perrier, Alessio Imperiale, Salvatore Annunziata, Vittoria Rufini
Journal: Clinical Nuclear Medicine (2023)

Purpose The interactions between the administration of cold somatostatin analogs (cSAs) and their radiolabeled counterpart remain unclear, and discontinuation before imaging is still advised as a precaution. The aim of this systematic review is to evaluate the consequences of cSA administration on tumoral and surrounding healthy organs' uptake at somatostatin receptor (SSTR) imaging with SPECT or PET. Methods After registration of the study on Prospero (CRD42022360260), an electronic search of PubMed and Scopus databases was performed. Inclusion criteria were as follows: human patients referred for SSTR imaging for oncological purposes; at least 1 examination performed either before cSA administration or after a long-enough withdrawal of cSA treatment; at least 1 examination was performed under cSA treatment. Included articles were independently appraised by 2 authors using the standardized protocol provided by the Quality Assessment of Diagnostic Accuracy Studies. Discrepancies were solved by consensus. Results A total of 12 articles were included, 4 using 111 In-pentetreotide and 8 using 68 Ga-DOTA peptides. Administration of cSAs consistently resulted in decreased spleen and liver uptake (from 6.9% to 80% for spleen, 10% to 60% for liver) and increased tumor-to-background or tumor–to–healthy organ ratios. After cSA treatment, tumor uptake alone was unchanged or moderately decreased. Similar results were noted whether patient was octreotide-naive. Conclusion Impairment in SSTR imaging quality after cSA administration has not been demonstrated. On the contrary, the administration of cSAs seems to improve the contrast between tumoral lesions and the surroundings.